In the last five years the federal government has adopted regulatory initiative in the health field that were considered politically infeasible a few years before. By supporting four major programs--Professional Standards Review Organizations, state certificate-of-need review of hospital expansion, state rate-setting of hospital (and other) charges, and area and state-wide planning by Health Systems Agencies--the federal government has committed itself to regulation by means of new organizations created and maintained at the state and local levels. Young though they are, these programs have already been subjected to the skepticism of policymakers convinced of the need for more direct controls by statutory and administrative means at the federal level. Unfortunately, very little is known about the ongoing development and workings of the programs that constitute the present decentralized approach. As a result, policymakers have a very poor empirical and analytical foundation for selecting the desirable extent and modes of health care regulation. The study proposed here intends to examine the workings of these four major regulatory programs in a sample of states and localities. By review of publications and agency files and through interviews, case studies of the agencies' influence upon the acquisition of new resources by providers, upon the allocation of services among social groups and regions, and upon other organizations' activities in areas of inter-dependence will be examined. Organization theory will be used to frame explanations of agency behavior. Specifically, attention will be paid to the organizations' structures, goals, political strategies, and interorganizational relations. The strengths and limits of these regulatory programs will be discussed in the larger context of health care politics in the United States, and recommendations for future regulatory directions will be offered.